After taking four doses of Plavix, my dad got a mild cardiac pain. Kindly help.

Question

Hello doctor,

My dad got three stents in his heart, one is five years ago, and the other two are 40 days ago. He is under medication for diabetes, hypertension and high cholesterol levels. The doctor prescribed him blood thinners, and Plavix was one of them. For the past five days, he did not take Plavix because his insurance went covering for it. When the doctor found out, he asked him to take eight doses of Plavix, once covered by insurance, which is the loading dose. However, my dad is stubborn and did not want to take eight doses and took only four doses. Yesterday after taking the fourth dose, he felt slight pain throughout the night. I am really worried now because he did not take what was recommended by a doctor. He is taking Plavix 75 mg every day as recommended by the doctor, but his pain in the chest seems concerning to me. His current medications are Aspirin, Atorvastatin, Famotidine, Glucophage, Losartan, Metoprolol and Plavix. Kindly give your suggestion.

Answer 1

Hello,

Welcome to icliniq.com.

Kindly answer me the following. Did he have similar pain during his recent cardiac event, or was it different? Is he having other symptoms like breathlessness, sweating or does this pain increase on exertion? In the prescription attached (attachments removed to protect patient's identity), Ticagrelor is prescribed instead of Plavix. The doctor has probably changed Ticagrelor to Plavix due to an insurance issue as Ticagrelor is a bit costly, but Ticagrelor and Plavix (Clopidogrel) are different. Now it is unusual to get cardiac chest pain after Plavix doses. However, gastritis and reflux due to Plavix is a likely possibility. Now reflux-related pain occurs intermittently at rest and maybe worse on lying down. In contrast, cardiac pain would increase on exertion and lessen on rest and may be associated with breathlessness. I suggest giving some antacid syrup if available to see if there is any response. Diabetic patients may not get severe pain, so take an ECG (electrocardiogram) to rule out the cardiac cause. I hope this helps you and get back if you have any more doubts. Thanks.